2025 KFF Marketplace Enrollees Survey
In 2025, about one in three ACA enrollees said they would be “very likely” to look for a lower-premium Marketplace plan If their premium payments doubled.
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In 2025, about one in three ACA enrollees said they would be “very likely” to look for a lower-premium Marketplace plan If their premium payments doubled.
Adults ages 50 to 64 are disproportionately affected by the expiration of ACA enhanced premium tax credits because they make up a large number of Marketplace enrollees and premiums rise with age.
Following the expiration of the enhanced premium tax credits for people with Affordable Care Act (ACA) Marketplace plans, a new KFF follow-up survey of the same Marketplace enrollees KFF surveyed in 2025 finds half (51%) of returning enrollees say their health care costs are “a lot higher” this year compared to last year, including four in 10 who specifically say their premiums are “a lot higher.”
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KFF estimates that, if Congress does not extend the enhanced premium tax credits, ACA Marketplace enrollees on average would see their premium payments more than double in 2026, growing by 114%, from an average of $888 in 2025 to $1,904 in 2026.
If you have two primary homes where you spend a significant amount of time, you can establish residency in either or both locations. To find in-network health care providers, carefully review the plan documents and provider directory before applying. You may want to explore plans that use a national provider network so that you can find participating health care providers in more than one state. A preferred provider organization (PPO) plan may offer more flexibility…
No. Insurers are not allowed to require people who owe back-due premiums to repay the premium debt before they will renew coverage for another year. You must be allowed to renew and your payment for January 1 cannot be applied to the back-due premium you owe. Going forward, keep in mind that insurers are allowed to cancel your coverage if you don't pay premiums. If you receive advance premium tax credits (APTC), insurers are required to…
Assuming that neither of you is claiming any dependents on your tax returns, you will each be considered a household of one, and your own incomes will be used to determine eligibility for and the amount of premium tax credits and cost-sharing reductions. If you are eligible for premium tax credits, you will each receive a separate determination of the amount of your credit and whether you are eligible for a cost-sharing reduction. If you…
Generally, no. Married taxpayers are required to file a joint tax return in order to qualify for premium tax credits. People who use the “married filing separately” status are not eligible to receive premium tax credits. However, there is a special exception for individuals who must file separately because of domestic abuse or spousal abandonment. For other married individuals who do not file a joint return, there may be other options. If you have a…
For the 2025 tax year, if you underestimated your income and received a larger advance premium tax credit than you were eligible for, you must repay the difference between the amount of tax credit you received and the amount you were eligible for. However, if your income is less than four times (400%) the federal poverty level, there are dollar limits on the amount you will have to repay for tax credits paid on your…
It depends on your household income and where you live. To give a general idea, a typical Silver plan might have an annual out-of-pocket maximum on all cost sharing of $10,600 in 2026. But if your income is between 100% and 150% of the federal poverty level ($15,650 to $23,475 annually for a single individual in 2026), the cost-sharing reductions will modify a Silver plan so that the annual out-of-pocket maximum on all cost sharing…
This FAQ was updated on January 14, 2026, to reflect the expiration of the enhanced premium tax credits. The premium tax credit enhancements that began in 2021 expired at the end of 2025 and have not been renewed by Congress. This means that many Marketplace enrollees eligible for premium tax credits will receive less financial assistance, and the amount they have to pay in monthly premiums has increased. Other Marketplace enrollees may no longer be…
It is important that you contact both the Marketplace and the health plan and let them know you no longer need coverage. Click here for details on how to terminate Marketplace coverage if you live in a HealthCare.gov state. State-based Marketplaces may have their own process for terminating coverage. Check with your state-based Marketplace for more information if you live in one of these states. Do not simply stop paying the premium for your Marketplace health plan…
Ten states currently provide eligible residents subsidies in addition to what the federal government provides for their Marketplace plans: • California • Colorado • Connecticut • Maryland • Massachusetts • New Jersey • New Mexico • New York • Vermont • Washington Check these state Marketplaces for more information. Click here for links to each state's website.
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